770 resultados para practitioner inquiry


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Background There will be increasing competition for young physicians worldwide as more and more physicians retire. While enthusiasm towards GP work is important for GP teachers as role models, satisfaction within the profession has declined. This study aims to determine if medical students’ desire to become GPs is related to the job satisfaction of their teaching GPs and explore the factors tied to this job satisfaction. Methods In this cross-sectional, correlational study, teaching GPs of the University of Bern and the fourth year medical students completing internships with them filled in separate questionnaires. Results Whether or not the GP teacher is perceived by a student to be satisfied with her/his job is correlated to that student’s satisfaction with the internship, which in turn, is correlated with student’s wish to be a GP after the internship. Results show which factors are most related to GP job satisfaction and the effect of working hours and their composition. Conclusions Medical students’ perception of their GP teachers’ job satisfaction positively affect their wish to become GPs, and their satisfaction with their internships adds to this. Enhancing the positive aspects of GP work, such as recognition, and improving negative ones, such as administrative duties, are necessary to attract medical students into the GP field.

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by Joseph Jacobs

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by Hermann L. Strack. The English transl. by Henry Blanchamp

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statement of G. W. Pieritz

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Purpose. To investigate and understand the illness experiences of patients and their family members living with congestive heart failure (CHF). ^ Design. Focused ethnographic design. ^ Setting. One outpatient cardiology clinic, two outpatient heart failure clinics, and informants' homes in a large metropolitan city located in southeast Texas. ^ Sample. A purposeful sampling technique was used to select a sample of 28 informants. The following somewhat overlapping, sampling strategies were used to implement the purposeful method: criterion; typical case; operational construct; maximum variation; atypical case; opportunistic; and confirming and disconfirming case sampling. ^ Methods. Naturalistic inquiry consisted of data collected from observations, participant observations, and interviews. Open-ended semi-structured illness narrative interviews included questions designed to elicit informant's explanatory models of the illness, which served as a synthesizing framework for the analysis. A thematic analysis process was conducted through domain analysis and construction of data into themes and sub-themes. Credibility was enhanced through informant verification and a process of peer debriefing. ^ Findings. Thematic analysis revealed that patients and their family members living with CHF experience a process of disruption, incoherence, and reconciling. Reconciling emerged as the salient experience described by informants. Sub-themes of reconciling that emerged from the analysis included: struggling; participating in partnerships; finding purpose and meaning in the illness experience; and surrendering. ^ Conclusions. Understanding the experiences described in this study allows for a better understanding of living with CHF in everyday life. Findings from this study suggest that the experience of living with CHF entails more than the medical story can tell. It is important for nurses and other providers to understand the experiences of this population in order to develop appropriate treatment plans in a successful practitioner-patient partnership. ^

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A workflow flowchart on the verification steps involved in preparation to uploading assets to the University of Connecticut's institutional repository (http://digitalcommons.uconn.edu). This flowchart is geared towards assisting subject liaisons who also serve as series administrators for UConn@DigitalCommons.

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Recent mathematics education reform efforts call for the instantiation of mathematics classroom environments where students have opportunities to reason and construct their understandings as part of a community of learners. Despite some successes, traditional models of instruction still dominate the educational landscape. This limited success can be attributed, in part, to an underdeveloped understanding of the roles teachers must enact to successfully organize and participate in collaborative classroom practices. Towards this end, an in-depth longitudinal case study of a collaborative high school mathematics classroom was undertaken guided by the following two questions: What roles do these collaborative practices require of teacher and students? How does the community’s capacity to engage in collaborative practices develop over time? The analyses produced two conceptual models: one of the teacher’s role, along with specific instructional strategies the teacher used to organize a collaborative learning environment, and the second of the process by which the class’s capacity to participate in collaborative inquiry practices developed over time.

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Background. Assessing the health status of adolescents is challenging for health care providers. Personal disclosure has been associated with improved health outcomes. Story-centered care was examined as an intervention for promoting adolescent disclosure during an urgent care visit. ^ Objectives. This study explored: (1) the effectiveness of story-centered care for promoting adolescent disclosure; (2) health-associated words used by adolescents to describe pressing concerns after an urgent care visit when they had standard care (SC) or story-centered care (SCC) conducted by a Nurse Practitioner (NP). ^ Methods. Subjects were randomly assigned to SC or SCC. In SC, adolescent presenting concerns were identified and treated. In SCC, presenting concerns were treated and NP-adolescent dialogue, facilitated through a screening tool, queried matters of importance to adolescent life. After the visit, adolescents wrote about pressing concerns for 15 minutes. Written words were analyzed with Linguistic Inquiry and Word Count, a software program for analyzing narrative. Ratios were calculated for the number of words (adolescent: NP) used during the urgent care visit. Analysis of variance (ANOVA) was used to evaluate gender-intervention differences in health-associated words. ^ Results. One hundred and six adolescents [Hispanic (65%), White (35%)] completed the study. Fifty-five were female; the average age was 17 (sd = 2.1) years. ^ Adolescents in the story intervention used more words (adolescent: NP, 1:1.3) than those in standard intervention (adolescent: NP, 1:2.7) in proportion to the number of words used by the NP during the urgent care visit. There were gender-intervention differences (p < .01) in positive emotion words and past-tense words in writings about pressing concerns. Males who received the story intervention used more positive emotion and less past-tense words than adolescent males with standard care. Females used more social words (p < .01) in their writings regardless of intervention group. ^ Conclusion. SCC enhanced adolescent disclosure during an urgent care visit. Adolescents will talk to health care providers during episodic visits and males may benefit more than girls may from this approach. Evidence suggests there is value in attending to both presenting and pressing concerns of adolescents. ^

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A review of 1985 neonatal death statistics in the Lower Rio Grande Valley of Texas revealed an excessive perinatal death rate among Hispanics compared to Anglos. In order to identify factors contributing to perinatal mortality in the region and to determine if existing perinatal services were adequate, a confidential inquiry into each 1988 perinatal death was performed.^ Medical risk factors in the mothers were infrequent. The most commonly noted pregnancy complication was polyhydramnios. This complication is often associated with anencephalus which was the most frequent birth anomaly detected in the region.^ The study results did not reveal an association between lay midwife deliveries in the region and excessive perinatal mortality nor did perinatal mortality appear to be associated with a lack of neonatal intensive care facilities. Lack of prenatal care was the most commonly encountered preventable factor associated with perinatal death. It was not possible to determine if the level of care for Anglos and Hispanics differed because of the low number of Anglo deaths although the socioeconomic level of deaths in each of the ethnic groups was the same. ^

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This paper focuses on examples of educational tools concerning the learning of chemistry for engineering students through different daily life cases. These tools were developed during the past few years for enhancing the active role of students. They refer to cases about mineral water, medicaments, dentifrices and informative panels about solar power, where an adequate quantitative treatment through stoichiometry calculations allows the interpretation of data and values announced by manufacturers. These cases were developed in the context of an inquiry-guided instruction model. By bringing tangible chemistry examples into the classroom we provide an opportunity for engineering students to apply this science to familiar products in hopes that they will appreciate chemistry more, will be motivated to study concepts in greater detail, and will connect the relevance of chemistry to everyday life.